PURPOSE: To evaluate whether treatment with single-agent docetaxel would result in longer survival than would best supportive care in patients with non–small-cell lung cancer who had previously been treated with platinum-based chemotherapy. Secondary end points included assessment of response (docetaxel arm only), toxicity, and quality of life. PATIENTS AND METHODS: Patients with performance statuses of 0 to 2 and stage IIIB/IV non–small-cell lung cancer with either measurable or evaluable lesions were eligible for entry onto the study if they had undergone one or more platinum-based chemotherapy regimens and if they had adequate hematology and biochemistry parameters. They were excluded if they had symptomatic brain metastases or if they had previously been treated with paclitaxel. Patients were stratified by performance status and best response to cisplatin chemotherapy and were then randomized to treatment with docetaxel 100 mg/m2 (49 patients) or 75 mg/m2 (55 patients) or best supportive care. Patient...

Prospective Randomized Trial of Docetaxel Versus Best Supportive Care in Patients With Non–Small-Cell Lung Cancer Previously Treated With Platinum-Based Chemotherapy

In past years, there has been considerable pessimism over the role of chemotherapy in non-small cell lung cancers. The pessimism was largely derived from the fact that alkylating agent-based therapies shortened survival and produced severe side effects. This was especially important because the vast majority of patients (approximately 85%) develop metastatic disease during their course. Randomized trials from the 1980s showed that cisplatin-based chemotherapy improved patient survival, improved quality of life as assessed by the patients, and relieved symptoms in the majority of symptomatic patients. When chemotherapy was administered on an outpatient basis, it actually lowered the total patient care costs for advanced stage patients. In the 1990s, five new agents, including two taxanes (paclitaxel, docetaxel), gemcitabine, navelbine, and irinotecan, were shown to produce higher response rates and longer survival in Phase II trials compared to cisplatin or carboplatin. In randomized trials, combinations of paclitaxel, gemcitabine, and vinorelbine with cisplatin improved the survival of advanced stage patients compared to cisplatin alone or in combination with etoposide. The toxicity profile of the new agents is also favorable compared to cisplatin-based therapy. Preliminary results in earlier stages are also encouraging. Thus, currently available chemotherapy given to non-small cell lung cancer patients with good performance status can improve survival to a similar extent as other solid tumors, such as small cell lung cancer and breast cancer.

https://clincancerres.aacrjournals.org/content/clincanres/4/5/1087.full.pdf

New chemotherapeutic agents prolong survival and improve quality of life in non-small cell lung cancer: a review of the literature and future directions.

Oral infections caused by yeast of the genus Candida and particularly Candida albicans (oral candidoses) have been recognised throughout recorded history However, since the 1980s a clear surge of interest and associated research into these infections have occurred This has largely been due to an increased incidence of oral candidosis over this period, primarily because of the escalation in HIV-infection and the AIDS epidemic In addition, changes in medical practice leading to a greater use of invasive clinical procedures and a more widespread use of immunosuppressive therapies have also contributed to the problem Whilst oral candidosis has previously been considered to be a disease mainly of the elderly and very young, its occurrence throughout the general population is now recognised Candida are true 'opportunistic pathogens' and only instigate oral infection when there is an underlying predisposing condition in the host Treatment of these infections has continued (and in some regards continues) to be problematic because of the potential toxicity of traditional antifungal agents against host cells The problem has been compounded by the emergence of Candida species other than C albicans that have inherent resistance against traditional antifungals The aim of this review is to give the reader a contemporary overview of oral candidosis, the organisms involved, and the management strategies that are currently employed or could be utilised in the future

https://www.tandfonline.com/doi/pdf/10.3402/jom.v3i0.5771

Pathogenesis and treatment of oral candidosis

Quality of life assessment of second-line docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy: results of a prospective, randomized phase III trial

Recent progress in medical sciences and therapy resulted in an increased number of immunocompromised individuals. Candida albicans is the leading opportunistic fungal pathogen causing infections in humans, ranging from superficial mucosal lesions to disseminated or bloodstream candidiasis. Superficial candidiasis not always presents a risk to the life of the infected host, however it significantly lowers the quality of life. Superficial Candida infections are difficult to treat and their frequency of occurrence is currently rising. To implement successful treatment doctors should be up to date with better understanding of C. albicans resistance mechanisms. Despite high frequency of Candida infections there is a limited number of antimycotics available for therapy. This review focuses on current understanding of the mode of action and resistance mechanisms to conventional and emerging antifungal agents for treatment of superficial and mucosal candidiasis.

/pdf/antifungal-agents-commonly-used-in-the-superficial-and-2muob3j8kf.pdf

Antifungal agents commonly used in the superficial and mucosal candidiasis treatment: mode of action and resistance development.

Objective

We investigated the effects of rheumatic diseases on oral symptoms, health habits, and quality of life in subjects with and without rheumatic diseases. The hypothesis was that patients with rheumatic diseases have more oral symptoms impairing their quality of life than healthy controls.



Methods

A questionnaire was mailed to a random sample of 1500 members of the Finnish Rheumatism Association, including those with and without rheumatic diseases. We focused on symptoms of the mouth and temporomandibular area, and health habits. Oral Health Impact Profile (OHIP14) was used to evaluate the oral health-related quality of life. We analyzed differences between subjects with and without rheumatic diseases, controlled for age, gender, smoking, and non-rheumatic chronic diseases.



Results

Completed questionnaires were received from 995 participants (response rate 66%). Of them, 564 reported rheumatic disease, 431 were used as controls. The patients reported significantly more all orofacial symptoms than controls. Severe dry mouth was reported by 19.6% of patients and 2.9% of controls (P < 0.001), and temporomandibular joint symptoms by 59.2% and 27.2% (P < 0.001), respectively. In the OHIP-14 questionnaire, the mean total score was significantly higher in patients (8.80 ± 11.15) than in controls (3.93 ± 6.60; P < 0.001).



Conclusion

The study hypothesis was confirmed by showing that the patients with rheumatic diseases reported oral discomfort and reduced quality of life more often when compared with controls.

Impact of rheumatic diseases on oral health and quality of life.

To assess the prevalence and antifungal drug sensitivity of non-albicans Candida (NAC) species in elderly outpatients. Materials and methods: We investigated oral rinse samples of 194 self-caring elderly population (mean age 83 years) with emphasis on background factors for harbouring NAC. Susceptibility of Candida species to antifungal drugs was determined using standard methodology. Multiple logistic regression analysis was performed taking positive NAC count as the dependent variable and a number of known Candida risk factors as independent variables. Results: Prevalence of candidal carriage of the population was 78.4%, of which 0.5% of the subjects were NAC positive. Candida dubliniensis was the most prevalent NAC species, followed by Candida glabrata and Candida parapsilosis. The NAC positive elderly were more often edentulous with dental prostheses or had fewer teeth than Candida albicans-positive or yeast-negative subjects. Dental caries slightly increased the risk for having NAC strains (odds ratio 1.08), whilst greater age appeared to lower the risk (odds ratio 0.77). Candida species were susceptible to the commonly used antifungal agents in general, but with considerable variation among species. Occasionally, some NAC exhibited lower antifungal susceptibility. Conclusion: The possibility of oral reservoirs of NAC strains which are resistant to common antifungals should be noted in elderly outpatients.

Prevalence and antifungal drug sensitivity of non-albicans Candida in oral rinse samples of self-caring elderly.

Minimal Important Change for the Visual Analogue Scale Foot and Ankle (VAS-FA)

Minimal important change for Foot and Ankle Outcome Score (FAOS).

Purpose The effect of surgical specialty on the outcomes of paediatric patients treated for displaced supracondylar humeral fractures remains unclear. The results of residents, paediatric ...

Antti J. Saarinen

Papers

Impact of rheumatic diseases on oral health and quality of life.

Prevalence and antifungal drug sensitivity of non-albicans Candida in oral rinse samples of self-caring elderly.

Minimal Important Change for the Visual Analogue Scale Foot and Ankle (VAS-FA)

Minimal important change for Foot and Ankle Outcome Score (FAOS).

Paediatric supracondylar humeral fractures: the effect of the surgical specialty on the outcomes.